Sysmex Journal International Vol.28 No.

1 (2018)

Performance Comparison of Two Sysmex Hematology

Analyzers: the XN-550 and the XS-1000i
Qian-Yun ZHANG*1, Jill CRIST*2, Tiffany IVERS*2
*1
Department of Pathology, University of New Mexico & TriCore Reference Laboratories, Albuquerque, NM, USA
*2
Sysmex America, Inc., Lincolnshire, IL, USA

INTRODUCTION to the existing The Automated Hematology Analyzer XS-

1000i (XS-1000i; Sysmex Corporation, Kobe, Japan)
desktop analyzer, and to provide additional data
1. Purpose demonstrating the precision and linearity of several
Since 2011, Sysmex has been offering the XN-Series of parameters of the XN-L Series. This study was
hematology analyzers to support the needs of large performed to evaluate the analytical performance of this
clinical laboratories. With the global introduction of the instrument for the US market.
XN-L Series in 2015, similar functionality, operability,
and clinical parameters 1,2,3,4) as the XN-Series are now
available in a compact, automated, hematology analyzer 2. About the XN-L Series of analyzers
well-suited for the small to medium-sized lab; for acute The XN-L Series of analyzers uses the proven
care settings; or for use in emerging markets where a technologies of flow cytometry [for white blood cells
larger analyzer may neither be cost-effective nor (WBC)], fluorescence flow cytometry [for white blood
practical. The XN-L Series is also suitable as a backup cell differential (WBC DIFF) and reticulocyte count
analyzer where an XN-Series analyzer is already installed (RET)], direct current impedance method with
because they share the same user interface, reagents, and hydrodynamic focusing [for red blood cell (RBC) and
control solutions along with the accuracy and linearity platelet (PLT)], and cyanide-free SLS (sodium lauryl
compared with the XN-Series that has already been sulfate) methods [for hemoglobin (HGB)] that are used in
characterized 1,5). the XN-Series and proven to be accurate 6) and reliable.
This series offers testing modes including whole blood
The purpose of this study was to demonstrate that the (WB), low WBC (LWBC), pre-dilute (PD), and body
analytical performance of The Automated Hematology fluid (BF) along with 35 reportable whole blood
Analyzer XN-550 (XN-550; Sysmex Corporation, Kobe, parameters and seven body fluid parameters as shown in
Japan), one of the XN-L Series analyzers, is comparable Table 1 7).

Table 1 Reportable parameters for the XN-L SeriesTM in the US

* Indicates optional feature with activated license

[Whole Blood] mode / [Low WBC] mode* / [Pre-Dilute] mode

Detector / Channel Parameter
WDF WBC, NEUT#, LYMPH#, MONO#, EO#, BASO#, NEUT%, LYMPH%,
RBC/PLT MONO%, EO%, BASO%, IG#, IG%
RBC, HCT, MCV, MCH, MCHC, PLT, RDW-SD, RDW-CV, MPV
HGB HGB
RET RET%*, RET#*, IRF*, RET-He*
[Body Fluid] mode*
Detector / Channel Parameter
WDF WBC-BF, MN#, MN%, PMN#, PMN%, TC-BF#
RBC/PLT RBC-BF

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 Sysmex Journal International Vol.28 No.1 (2018)

Comprised of three main instruments, the XN-L Series instruments include an embedded IPU (information
offerings differ primarily in automation features and tube processing unit) with touchscreen display.
handling capabilities. Samples can be run by manual The XN-L Series may serve as a replacement for the XS-
analysis, which requires the medical laboratory scientist 1000i, the Sysmex legacy analyzer. Compared with this
to physically hold a single sample up to the aspiration analyzer, the XN-L Series offers the following
sensor or place it in the analyzer for testing; or by improvements and features including additional
sampler analysis, which involves loading multiple sample parameters and testing modes, onboard rules, and
tubes into a testing rack which then automatically increased storage capability (Table 2). Upon comparison
approach the aspiration sensor for analysis. The of the two instruments notable channel improvements for
Automated Hematology Analyzer XN-350 (XN-350; the XN-L Series include the addition of a reticulocyte
Sysmex Corporation, Kobe, Japan) accommodates (RET) detection channel and an enhanced WDF channel
manual analysis with open-tube sampling, while The for differential counting.
Automated Hematology Analyzer XN-450 (XN-450;
Sysmex Corporation, Kobe, Japan) also uses single Table 3 summarizes key features between the XN, XN-L
sample analysis and, in addition, offers both open-tube and XS-1000i Series of instruments. The XN-L offers
sampling and cap-piercing closed sampling functions. enhanced nRBC flagging compared to the XS-1000i
The largest and most fully equipped XN-550 comes Series as well as many of the same features as the XN-
standard with a continuous-feed autoloader and features Series.
automated repeat/rerun/reflex capability. All three

Table 2 Feature comparison of XN-L Series and XS-1000i Series in the US

XN-L Series XS-1000i Series

Aspiration volume: 25 µL (WB mode) Aspiration volume: 20 µL (open/closed mode)

WB mode: Up to 60 samples/hour Single Sample Mode: 60 samples/hour

Auto Sampler Mode: 53 samples/hour
6-part differential with IG 5-part differential
NEUT, LYMPH, MONO, EO, BASO, IG NEUT, LYMPH, MONO, EO, BASO
Enhanced nRBC flagging nRBC flagging
RET channel (reticulocyte) Not available
license optional at time of purchase
BF (body fluid mode) Not available
license optional at time of purchase
Low WBC mode Not available
Onboard Rules: None
XN-350 - Action message
XN-450 - Action message
XN-550 - Automatic repeat, rerun, reflex
100,000 result storage 10,000 result storage

Table 3 Feature comparison between XN, XN-L, and XS-1000i Series analyzers

XN Series XN-L Series XS-1000i Series

Immature Granulocyte (IG) Yes Yes Not available
Enumerated nRBC Yes Flagging only Flagging only
Reticulocytes with RET-He Yes Yes (optional) Not available
Automatic body fluid testing Yes Yes (optional) Not available
Onboard rules Yes Yes Not available
Repeat/reflex testing Yes Yes Not available
Patient results in browser (#) 100,000 100,000 10,000
Quality Control files (#) 99 99 20

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 Sysmex Journal International Vol.28 No.1 (2018)

Table 4 lists sample volume requirements for whole Table 5 summarizes sample throughput for whole blood,
blood, pre-diluted blood, and body fluids 8). Depending low WBC samples, pre-diluted blood, and body fluids.
on the collection tube chosen, sample volume Depending on the tests run, sample throughput of up to
requirements can be as low as 250 µL for the sampler 60 samples per hour is possible.
mode or 100 µL (WB), 140 µL (PD or BF) for manual
analysis. (Table adapted from Hamaguchi Y, Kondo T, Nakai R,
Ochi Y, Okazaki T, Uchihashi K, Morikawa T.
(Table adapted from Hamaguchi Y, Kondo T, Nakai R, Introduction of Products: Overview and Features of the
Ochi Y, Okazaki T, Uchihashi K, Morikawa T. Automated Hematology Analyzer XN-L Series. Sysmex
Introduction of Products: Overview and Features of the Journal International. 2015;25(1))
Automated Hematology Analyzer XN-L Series. Sysmex
Journal International. 2015;25(1))

Table 4 Sample volume requirements for XN-L Series

1. Use diluted blood prepared by diluting 20É L of whole blood 1:7
2. The availability of body fluid analysis function depends on the system configuration

Required Aspirated
Analysis method Specimen Test tube Cap sample sample
volume volume
Sampler analysis Whole blood Regular sample tube Closed 1 mL 25 µL
Raised bottom tube
(RBT) micro collection Closed 250 µL
tube
Manual analysis Whole blood Regular sample tube Closed 1 mL 25 µL
Open 300 µL
RBT micro collection tube Closed 250 µL
Micro collection tube Open 100 µL
Diluted blood Regular sample tube Open 300 µL 70 µL1
Micro collection tube Open 140 µL
Body fluid 2 Regular sample tube Closed 1 mL 70 µL
Open 300 µL
Micro collection tube Closed 140 µL

Table 5 Throughput of XN-L for various samples

1. Throughput depends on the system configuration
2. Availability of functions depends on the system configurations

Analysis mode Discrete Throughput

Whole blood CBC Approx. 60 samples/hour
CBC+DIFF
CBC+RET 2 Approx. 35 samples/hour
CBC+DIFF+RET 2
Low WBC 2 CBC+DIFF Approx. 55 samples/hour
CBC+DIFF+RET 2 Approx. 30 samples/hour
Pre-Dilute CBC Approx. 60 samples/hour
CBC+DIFF
CBC+DIFF+RET 2 Approx. 30 samples/hour
Body fluid 2 — Approx. 30 samples/hour

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 Sysmex Journal International Vol.28 No.1 (2018)

2. Testing criteria
MATERIALS AND METHODS 1) Correlation between the Sysmex XN-550 and the XS-
1000i analyzers
The instrument performance evaluation comparing the Between 175 and 195 residual whole blood samples were
Sysmex XN-550 with the Sysmex XS-1000i was analyzed using all analysis modes on XN-550. The
conducted at TriCore Reference Laboratories, variation in sample size was due to instrument-excluded
Albuquerque, NM. samples and those excluded manually due to insufficient
sample quantity or inadequate mixing.
Standard practice protocols and statistical analysis were The same samples were also run on the XS-1000i and
used to evaluate the analyzers in the following areas: correlation coefficients were calculated using EP
1. Correlation between the Sysmex XN-550 and the XS- Evaluator software (Data Innovations LLC).
1000i analyzers
2. Linearity of the XN-550 results Statistical Analysis
3. Precision/repeatability of the XN-550 using both pre- For each of the following tests listed in the table below,
dilute and whole blood samples sample data was displayed in Passing-Bablok 9) (scatter
plots) along with overlaid regression lines. In addition,
Both instruments were set up in accordance with industry regression statistics were presented.
standards and manufacturer recommendations.
2) Linearity of the XN-550
The linearity of a hematology instrument can be verified
1. Sample preparation by comparing the laboratory's reportable range with
The study was performed using human peripheral whole commercially available linearity assays. RANGE
blood samples collected in K2 EDTA. CHECK™ III and RET-CHECK™ II for reticulocytes
were used to verify the linearity of the XN-550
Abnormal samples were expected to represent various throughout its full range.
clinical conditions of platelet, white cell, and red cell
dysfunction. Special consideration was given to nRBCs, 3) Precision/repeatability of the XN-550 using both pre-
low platelets and immature or abnormal WBCs (i.e., dilute and whole blood samples
blasts, bands, immature granulocytes, variant Nine normal whole blood samples from healthy
lymphocytes) as well as RBC abnormalities (i.e., individuals were analyzed in series ten times on the
fragments, inclusions, or hemoglobinopathies). XN-550. Sample analysis was performed within four
hours of blood collection. The CV% and SD were
Samples were considered normal/negative if they met the calculated.
following criteria: The same nine samples were diluted (1:7) and analyzed
a) No clinical evidence of medical disorder known to ten consecutive times in the pre-dilute mode on the XN-
affect WBC or differential count 550. Sample analysis was completed within five hours of
b) CBC parameters within normal range blood collection. The CV% and SD were also calculated
c) Normal serum chemistry values (if available) and compared to data from the whole blood mode.

WBC White blood cells

RBC Red blood cells
HGB Hemoglobin
HCT Hematocrit
MCV Mean corpuscular volume
MCH Mean corpuscular hemoglobin
MCHC Mean corpuscular hemoglobin concentration
RDWSD Red cell distribution width — Standard deviation
RDWCV Red cell distribution width — Coefficient of variation
PLT Platelets
MPV Mean platelet volume
NEUT% Neutrophils, percentage
NEUT# Neutrophils, absolute
LYMPH% Lymphocytes, percentage
LYMPH# Lymphocytes, absolute
MONO% Monocytes, percentage
MONO# Monocytes, absolute
EO% Eosinophils, percentage
EO# Eosinophils, absolute
BASO% Basophils, percentage
BASO# Basophils, absolute

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 Sysmex Journal International Vol.28 No.1 (2018)

White blood cells, WBC (10 3/µL) Red blood cells, RBC (10 6/µL)
Scatter Scatter
y=0.976x+0.0305 y=1.015x-0.0031
r=0.9998 r=0.9958
n=195 n=195
XN-550

XN-550
XS-1000i ..........Deming regression XS-1000i ..........Deming regression

Hemoglobin, HGB (g/dL) Hematocrit, HCT (%)

Scatter Scatter
y=1.004x+0.12 y=0.998x-0.05
r=0.9955 r=0.9935
n=195 n=195
XN-550

XN-550

XS-1000i ..........Deming regression ..........Deming regression

XS-1000i

Mean corpuscular volume, MCV (fL) Mean corpuscular hemoglobin, MCH (pg/cell)
Scatter Scatter
y=0.954x+2.62 y=1.001x-0.04
r=0.9920 r=0.9920
n=195 n=195
XN-550

XN-550

XS-1000i ..........Deming regression XS-1000i ..........Deming regression

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 Sysmex Journal International Vol.28 No.1 (2018)

Mean corpuscular hemoglobin Red cell distribution width-

concentration, MCHC (g/dL) standard deviation, RDW-SD (fL)
Scatter Scatter
y=1.065x-1.63 y=1.083x-4.97
r=0.8935 r=0.9865
n=195 n=193
XN-550

XN-550
XS-1000i ..........Deming regression XS-1000i ..........Deming regression

Red cell distribution width-

coefficient of variation, RDW-CV (%) Platelets, PLT (10 3/µL)
Scatter Scatter
y=0.980x-0.23 y=1.010x+1.9
r=0.9926 r=0.9967
n=193 n=195
XN-550
XN-550

..........Deming regression XS-1000i ..........Deming regression

XS-1000i

Mean platelet volume, MPV (fL) Neutrophils, NEUT% (%)

Scatter Scatter
y=0.913x+0.64 y=0.982x+1.636
r=0.9545 r=0.9978
n=185 n=175
XN-550

XN-550

XS-1000i ..........Deming regression XS-1000i ..........Deming regression

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 Sysmex Journal International Vol.28 No.1 (2018)

Neutrophils, NEUT# (10 3/µL) Lymphocytes, LYMPH% (%)

Scatter Scatter
y=0.986x+0.009 y=1.020x+0.33
r=0.9984 r=0.9965
n=175 n=175
XN-550

XN-550
XS-1000i ..........Deming regression XS-1000i ..........Deming regression

Lymphocytes, LYMPH# (10 3/µL) Monocytes, MONO% (%)

Scatter
Scatter
y=0.898x-0.35
y=0.999x+0.040
r=0.9584
r=0.9999
n=175
n=175
XN-550
XN-550

XS-1000i ..........Deming regression

XS-1000i ..........Deming regression

Monocytes, MONO# (10 3/µL) Eosinophils, EO% (%)

Scatter Scatter
y=0.312x+0.346 y=1.011x-0.06
r=0.6449 r=0.9869
n=175 n=175
XN-550

XN-550

XS-1000i ..........Deming regression XS-1000i ..........Deming regression

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 Sysmex Journal International Vol.28 No.1 (2018)

Eosinophils, EO# (10 3/µL) Basophils, BASO% (%)

Scatter Scatter
y=1.000x-0.004 y=0.443x+0.28
r=0.9925 r=0.7885
n=175 n=175
XN-550

XN-550

XS-1000i ..........Deming regression XS-1000i ..........Deming regression

Basophils, BASO# (10 3/µL)

Scatter
y=0.458x+0.017
r=0.9354
n=175
XN-550

XS-1000i ..........Deming regression

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included in the following graphs. Each value produced by

RESULTS the XN-550 and XS-1000i are graphed in a scatter plot.
Ideal correlation would correspond to a slope of 1 with
an intercept of 0.
1. Correlation between the Sysmex XN-550 and
the XS-1000i analyzers Table 6 summarizes the key statistics of the
Data was presented using Passing-Bablok plots with measurements: sample size, ranges, correlations, and
Deming regression best fit lines. Deming regression was confidence intervals.
used instead of least-squares because Deming regression
is better suited to data where both the X and Y axis data All of the following blood components showed strong
may contain variability. These statistical methods are agreement with the measurements obtained from the XS-
recommended by the Clinical and Laboratory Standards 1000i with correlation coefficients ranging from 0.9354
Institute (CLSI) for handling patient samples 10). to 0.9999 and exhibiting low bias. Measurements of three
blood components (MCHC, BASO%, and MONO#)
Data and regression statistics for 21 parameters are demonstrated lower correlation (r < 0.90).

Table 6 Hematology method comparison — statistical summary — XS-1000i vs XN-550

Sample Result Correlation Standard error

Type of the estimate Slope 95% Confidence Intercept 95% Confidence
size (n) range coefficient (r) interval interval
(SEE)
WBC 195 0.130 to 277.290 1.000 0.504 0.976 0.973 to 0.979 0.031 -0.0465 to 0.1075
RBC 195 1.530 to 6.920 0.996 0.088 1.015 1.002 to 1.028 -0.003 -0.0598 to 0.0536
HGB 195 5.1 to 19.2 0.996 0.260 1.004 0.990 to 1.017 0.120 -0.06 to 0.29
HCT 195 15.7 to 59.8 0.994 0.880 0.998 0.982 to 1.014 -0.050 -0.68 to 0.58
MCV 195 64.0 to 131.0 0.992 1.130 0.954 0.937 to 0.971 2.620 1.04 to 4.21
MCH 195 19.3 to 43.3 0.992 0.450 1.001 0.983 to 1.019 -0.040 -0.60 to 0.52
MCHC 195 29.0 to 37.8 0.894 0.690 1.065 0.996 to 1.135 -1.630 -3.96 to 0.71
RDWSD 193 37.6 to 95.9 0.987 1.600 1.083 1.057 to 1.108 -4.970 -6.28 to -3.65
RDWCV 193 11.8 to 30.1 0.993 0.390 0.980 0.963 to 0.997 -0.230 -0.50 to 0.05
PLT 195 3 to 1295 0.997 11.300 1.010 0.999 to 1.022 1.900 -1.1 to 4.9
MPV 185 8.2 to 14.5 0.955 0.310 0.913 0.873 to 0.953 0.640 0.21 to 1.07
NEUT% 175 2.20 to 94.00 0.998 1.262 0.982 0.972 to 0.992 1.636 1.037 to 2.235
NEUT# 175 0.14 to 34.23 0.998 0.207 0.986 0.978 to 0.995 0.009 -0.039 to 0.058
LYMPH% 175 2.7 to 94.7 0.997 1.580 1.020 1.007 to 1.033 0.330 -0.11 to 0.77
LYMPH# 175 0.18 to 261.98 1.000 0.412 0.999 0.997 to 1.001 0.040 -0.022 to 0.103
MONO% 175 1.7 to 32.5 0.958 1.390 0.898 0.859 to 0.937 -0.350 -0.80 to 0.10
MONO# 175 0.02 to 9.09 0.645 0.310 0.312 0.261 to 0.362 0.346 0.285 to 0.407
EO% 175 0.0 to 13.5 0.987 0.360 1.011 0.987 to 1.036 -0.060 -0.13 to 0.02
EO# 175 0.00 to 1.02 0.993 0.019 1.000 0.981 to 1.018 -0.004 -0.008 to 0.000
BASO% 175 0.0 to 8.2 0.789 0.340 0.443 0.395 to 0.491 0.280 0.22 to 0.34
BASO# 175 0.00 to 1.68 0.935 0.025 0.458 0.432 to 0.483 0.017 0.013 to 0.021

High correlation (r > 0.90) Lower correlation (r < 0.90)

WBC, RBC, HGB, HCT, MCV, MCH, RDW-SD, MCHC, BASO%, and MONO#
RDW-CV, PLT, MPV, NEUT%, NEUT#, LYMPH%,
LYMPH#, MONO%, EO%, EO#, BASO#

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The same nine blood samples were then diluted (in a 1:7
2. Linearity of the XN-550 ratio) and processed again through the analyzer ten times
Table 7 lists the manufacturer's reported range and the using pre-dilute mode.
range reported by the study site for WBC, RBC, HGB,
HCT, PLT, and RET. The mean, standard deviation, and coefficient of
variation were computed and compared for both modes.
Graphs of linearity demonstrated that actual values Fig. 1 charts the mean CV% of the nine samples (i.e.,
tracked expected values closely for WBC, RBC, HGB, Sample 1 CV% + Sample 2 CV% + .... + Sample 9 CV%
HCT, PLT, and RET. A coefficient of determination for divided by 9).
all tests ranged between 0.999 and 1.000 for
manufacturer-established linearity. The figure below shows the mean CV% plotted against
all the blood components for both pre-diluted and for
whole blood.
3. Precision/repeatability of the XN-550 using
both pre-dilute and whole blood samples of all Fig. 1: Mean CV% of nine samples each of PD(Pre-
parameters from all channels Dilute) and WB(Whole Blood)
To determine repeatability, nine whole blood samples
were processed through the XN-550 analyzer ten times
each.

Table 7 Manufacturer's stated and measured ranges

Sysmex TriCore
Low High Low High
WBC, 10 3/µL 0 440 0 556.01
RBC, 10 6/µL 0 8.60 0 8.42
HGB, g/dL 0 26.0 0 27.5
HCT, % 0 75.0 0 74.2
PLT, 10 3/µL 0 5,000 0 5,681.5
RET, % 0 30.0 0 22.35

Fig. 1 Mean CV% of nine samples each of PD (Pre-Dilute) and WB (Whole Blood)

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DISCUSSION support the following medical specialties.

There was high correlation of results (r > 0.90) for most In urgent care settings the small footprint and high
parameters between the new XN-550 and the legacy throughput are beneficial when space and time are
analyzer XS-1000i. Lower correlations were seen for limited. Also the XN-L Series offers the automated
MCHC, BASO%, and MONO#. Immature Granulocyte (IG) which may be an indication
of infection or inflammation. Body fluid analysis (BF
Correlation for mean cell hemoglobin content (MCHC) mode) is available for use with cerebrospinal, serous and
presented with a lower value than the other parameters at synovial fluids which may reduce the need for more time
r = 0.8935, possibly due to a narrow distribution of consuming manual laboratory methods. The BF mode
sample data in the middle of the range of values skewing offers a total cell count, WBC, RBC, and a two-part
the regression curve. Bias was low, however, at 1.7%, differential for standardized body fluid analysis.
and the data points appeared generally in line.
Physician office laboratories handling family practice,
Similarly, the relative basophil count (BASO%) internal medicine and pediatric patients have opportunity
presented with a lower regression, r = 0.7885 and a bias with the XN-L Series analyzers. Accurate results make
of -13.4%. This may be explained given that basophils this system a must for routine health screening and the
are far fewer in number relative to the other types of routine care of patients with chronic conditions. Pediatric
WBCs and this level of variability has been reported in populations can benefit from the low sample aspiration
other studies 4). The BASO# also demonstrated a similar volume of 25 µL and the enhanced nRBC flagging
falloff at higher values, but the coefficient of correlation capabilities. By decreasing the amount of blood drawn
remained high (r = 0.9354). Bias was greater than most from these children the risk of phlebotomy-induced
of the other values as well at -21.1%. Most of the data anemia is reduced. As some estimates suggest that iron
points were below 1.5% and this tends to make the deficiency affects roughly ten percent of the pediatric
regression line more sensitive to smaller changes than if population, the RET-H e parameter (Reticulocyte
the data was distributed more evenly. The difference in Hemoglobin Equivalent) has been shown to be a
BASO% may be due to the improved discrimination of sensitive marker to detect iron deficiency before it
cell populations in the XN-550 WDF channel as progresses to anemia.
compared to the DIFF channel on XS-1000i.
In dialysis centers these analyzers can offer a
The blood component with the lowest correlation (r = comprehensive reticulocyte panel including IRF and
0.6449) was for the monocyte absolute count, MONO#. RET-He. Anemia is often a chronic concern in kidney
Bias was higher than the other components at -25.7%. patients since erythropoietin stimulates red cell
The difference in MONO# may be due to the improved production in the bone marrow and it is naturally
discrimination of cell populations in the XN-550 WDF produced in the kidney. The RET-H e parameter is a
channel as compared to the DIFF channel on XS-1000i. sensitive way to detect iron deficiency earlier in chronic
kidney disease patients. It may be more useful than
Results showed very high correlation (r2 > 0.999) in traditional iron studies as it is not affected by
linearity throughout the full range of the instruments inflammation or the acute phase response.
design with no anomalies observed.
For oncology patients who present with leukocytopenia
Precision/repeatability was acceptable for both pre- secondary to chemotherapy and treatment, the XN-L
diluted and whole blood samples. Coefficient of variation analyzer offers accurate white cell measurements using
was low for most blood components; however, basophils Low WBC mode. By increasing the analysis duration
(BASO#, BASO%) and immature granulocyte count three times longer, more cell events are counted ensuring
(IG#, IG%) showed a higher degree of variation, possibly a more precise measurement on these usually challenging
due to improved resolution of scattergrams and limited specimens. For fast-paced oncology centers the
availability of samples with high values. continuous sample loading and auto rerun/reflex of the
XN-550 accommodates a high volume throughput with
Flagging performance, evaluation of the low WBC mode, minimal technologist intervention, therefore allowing
and performance of the manual analysis sampling method timely result reporting of absolute neutrophil counts.
were outside the scope of this study and may be reported
on in the future.
CONCLUSION
The XN-L Series has wide applicability in many
diagnostic areas because of its advanced capabilities, The XN-L Series of hematology analyzers demonstrates
small size, ease of use and commonality to the larger XN a high degree of correlation with the legacy XS-1000i
Series analyzers. The XN-L is especially well suited for instrument, has acceptable linearity throughout its full
use in urgent care and free standing emergency rooms, range of detection, and provides a high degree of
family practice and pediatric clinics, dialysis centers and repeatability for both whole blood and pre-diluted blood.
oncology units. This series of hematology analyzers XN-L can provide standardized testing from Core Lab to
delivers solutions for laboratories and clinics that offer satellite labs, and affiliated Clinics and Physician Office
niche diagnostic testing. Dedicated functionalities Laboratories. Improved functionality of the XN-L Series

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 Sysmex Journal International Vol.28 No.1 (2018)

analyzer over the XS-Series includes: a sampler with 3) Briggs C, Longair I, Kumar P, Singh D, Machin SJ. Performance
continuous sample loading, enhanced nRBC flagging, the evaluation of the Sysmex haematology XN modular system. J Clin
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virtual classrooms, in-person instruction, regional and Abnormal Cell Flagging Comparisons of Three Automated
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